Individual ProviderSusan A. MitchellSocial WorkerBehavioral Health & Social Service ProvidersPractice Address5965 S 900 E Ste 240, Salt Lake City, UT 84121-1720(801) 263-7231PECOS EnrollmentBased on the most recent information from CMS, provider Susan A. Mitchell does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1710965447Provider TypeIndividualFull NameMitchell, Susan A.TitleMs.CredentialLCSWGenderFemaleSole ProprietorNoEnumeration Date1/3/2006Last Updated10/28/2016Contact InformationPractice LocationPractice Address5965 S 900 E Ste 240, Salt Lake City, UT 84121-1720Phone(801) 263-7231FaxUnlisted FaxMailing LocationMailing Address3051 W Maple Loop Dr, Ste 210, Lehi, UT 84043-4602Phone(801) 263-7231FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense2662563501UtahCode101Y00000XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense2662563501UtahCode101YA0400XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense2662563501UtahCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense2662563501UtahProvider IdentifiersIDDescriptionIssuerID107001386101DescriptionOtherIssuerINTERMTN. HEALTH CAREUtahID94293834BDescriptionOtherIssuerCHAMPUSUtahID002200233DescriptionOtherIssuerRAILROAD MEDICAREUtahID262038DescriptionOtherIssuerDESERET MUTUALUtahID942938348MI2DescriptionOtherIssuerEDUCATORS MUTUALUtah